Parmigiani Sara, Cline Christopher C, Sarkar Manjima, Forman Lily, Truong Jade, Ross Jessica M, Gogulski Juha, Keller Corey J
Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA 94394, USA.
Clin Neurophysiol. 2025 Jun;174:225-234. doi: 10.1016/j.clinph.2025.02.261. Epub 2025 Mar 11.
We currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.
This closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20-60 ms) and local TMS-evoked potential (EL-TEP).
In 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.
Real-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP.
Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.
目前我们缺乏一种可靠的非侵入性方法来测量人类前额叶兴奋性。前额叶皮质中的同步经颅磁刺激（TMS）和脑电图（EEG）通常会受到伪迹的干扰。在此，我们探讨实时优化是否可以减少伪迹并增强对左前额叶兴奋性的TMS-EEG测量。
这种闭环优化程序基于对TMS的EEG反应实时调整左背外侧前额叶皮质（dlPFC）TMS线圈的位置、角度和强度。我们的结果指标是左前额叶早期（20 - 60毫秒）局部TMS诱发电位（EL-TEP）。
在18名健康参与者中，与未优化的方法相比，这种对线圈角度和脑靶点的优化显著减少了63%的伪迹，并且在强度增加的情况下，EL-TEP幅度增加了75%。
在dlPFC刺激期间对TMS参数进行实时优化可以增强EL-TEP。
增强我们测量前额叶兴奋性的能力对于监测病理状态和治疗反应非常重要。
